Cloud algorithm-driven oximetry-based diagnosis of obstructive sleep apnoea in symptomatic habitually snoring children

Abstract

The ability of a cloud-driven Bluetooth oximetry-based algorithm to diagnose obstructive sleep apnoea syndrome (OSAS) was examined in habitually snoring children concurrently undergoing overnight polysomnography. Children clinically referred for overnight in-laboratory polysomnographic evaluation for suspected OSAS were simultaneously hooked to a Bluetooth oximeter linked to a smartphone. Polysomnography findings were scored and the apnoea/hypopnoea index (AHIPSG) was tabulated, while oximetry data yielded an estimated AHIOXI using a validated algorithm. The accuracy of the oximeter in identifying correctly patients with OSAS in general, or with mild (AHI 1-5 events h-1), moderate (5-10 events h-1) or severe (>10 events h-1) OSAS was examined in 432 subjects (6.5±3.2 years), with 343 having AHIPSG >1 event h-1. The accuracies of AHIOXI were consistently >79% for all levels of OSAS severity, and specificity was particularly favourable for AHI >10 events h-1 (92.7%). Using the criterion of AHIPSG >1 event h-1, only 4.7% of false-negative cases emerged, from which only 0.6% of cases showed moderate or severe OSAS. Overnight oximetry processed via Bluetooth technology by a cloud-based machine learning-derived algorithm can reliably diagnose OSAS in children with clinical symptoms suggestive of the disease. This approach provides virtually limitless scalability and should alleviate the substantial difficulties in accessing paediatric sleep laboratories while markedly reducing the costs of OSAS diagnosis.